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Short Androgen Suppression and Radiation Dose Escalation in Prostate Cancer: 12-Year Results of EORTC Trial 22991 in Patients With Localized Intermediate-Risk Disease
M. Bolla, A. Neven, P. Maingon, C. Carrie, A. Boladeras, D. Andreopoulos, A. Engelen, S. Sundar, EM. van der Steen-Banasik, J. Armstrong, K. Peignaux-Casasnovas, J. Boustani, FG. Herrera, BR. Pieters, A. Slot, A. Bahl, CD. Scrase, D. Azria, J....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 2004 do Před 1 rokem
Open Access Digital Library
od 1999-01-01
PubMed
34310202
DOI
10.1200/jco.21.00855
Knihovny.cz E-zdroje
- MeSH
- antagonisté androgenů farmakologie terapeutické užití MeSH
- časové faktory MeSH
- dávka záření MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty farmakoterapie radioterapie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: The European Organisation for Research and Treatment of Cancer (EORTC) trial 22991 (NCT00021450) showed that 6 months of concomitant and adjuvant androgen suppression (AS) improves event- (EFS, Phoenix) and clinical disease-free survival (DFS) of intermediate- and high-risk localized prostatic carcinoma, treated by external-beam radiotherapy (EBRT) at 70-78 Gy. We report the long-term results in intermediate-risk patients treated with 74 or 78 Gy EBRT, as per current guidelines. PATIENT AND METHODS: Of 819 patients randomly assigned between EBRT or EBRT plus AS started on day 1 of EBRT, 481 entered with intermediate risk (International Union Against Cancer TNM 1997 cT1b-c or T2a with prostate-specific antigen (PSA) ≥ 10 ng/mL or Gleason ≤ 7 and PSA ≤ 20 ng/mL, N0M0) and had EBRT planned at 74 (342 patients, 71.1%) or 78 Gy (139 patients, 28.9%). We report the trial primary end point EFS, DFS, distant metastasis-free survival (DMFS), and overall survival (OS) by intention-to-treat stratified by EBRT dose at two-sided α = 5%. RESULTS: At a median follow-up of 12.2 years, 92 of 245 patients and 132 of 236 had EFS events in the EBRT plus AS and EBRT arm, respectively, mostly PSA relapse (48.7%) or death (45.1%). EBRT plus AS improved EFS and DFS (hazard ratio [HR] = 0.53; CI, 0.41 to 0.70; P < .001 and HR = 0.67; CI, 0.49 to 0.90; P = .008). At 10 years, DMFS was 79.3% (CI, 73.4 to 84.0) with EBRT plus AS and 72.7% (CI, 66.2 to 78.2) with EBRT (HR = 0.74; CI, 0.53 to 1.02; P = .065). With 140 deaths (EBRT plus AS: 64; EBRT: 76), 10-year OS was 80.0% (CI, 74.1 to 84.7) with EBRT plus AS and 74.3% (CI, 67.8 to 79.7) with EBRT, but not statistically significantly different (HR = 0.74; CI, 0.53 to 1.04; P = .082). CONCLUSION: Six months of concomitant and adjuvant AS statistically significantly improves EFS and DFS in intermediate-risk prostatic carcinoma, treated by irradiation at 74 or 78 Gy. The effects on OS and DMFS did not reach statistical significance.
European Organization for Research and Treatment of Cancer Brussels Belgium
Institut du Cancer de Montpellier Université de Montpellier INSERM U1194 Montpellier France
Institute Verbeeten Tilburg the Netherlands
Ipswich Hospital National Health Services Trust Ipswich United Kingdom
Klinika Onkologie a Radioterapie Fakultni nemocnice Hradec Kralove Hradec Kralove Czech Republic
Patrick G Johnston Centre for Cancer Research Queen's University Belfast Belfast Ireland
Radiation Oncology and Immuno Oncology Service University Hospital of Lausanne Lausanne Switzerland
Radiotherapeutisch Instituut Friesland Leeuwarden the Netherlands
Radiotherapiegroep Arnhem Arnhem the Netherlands
Radiotherapy Department Bank of Cyprus Oncology Centre Nicosia Cyprus
Radiotherapy Department Georges Francois Leclerc Centre Dijon France
Radiotherapy Department Leon Bérard Center Lyon France
Radiotherapy Department University Hospital of Besancon Jean Minjoz Hospital Besancon France
Sorbonne University APHP Sorbonne University La Pitié Salpêtrière Paris France
Citace poskytuje Crossref.org
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